Civil Defence ambulances hunted down in Eastern Ghouta

This is the second of a series of research blog posts investigating violations of international humanitarian law since the military offensive began on 18 February 2018 by Russian-backed Syrian government forces to root out armed opposition groups based in Eastern Ghouta, Syria.

Pro-government warplanes and forces appear to have deliberately targeted ambulances and buildings belonging to or used by the Syria Civil Defence (referred to in this blog as Civil Defence) in flagrant violation of international humanitarian law, which requires that the wounded and sick be collected and cared for and that medical transports be respected and protected at all times.

This blog documents attacks on four ambulances and three facilities belonging to or used by Markaz 114 (Centre 114) of the Civil Defence, also known as the White Helmets, resulting in the killing of four of its volunteers, Mahmoud al-Kilani, Yasser Sobhiye and brothers Ismail and Mohammad Hasheesh, wounding others, and causing destruction or damage to the centre’s property.

Markaz 114 is one of 12 Civil Defence centres operating in Eastern Ghouta, which has been under siege since 2013. Ambulances and facilities belonging to or used by other Civil Defence centres have been also hit since the beginning of the offensive, and another five volunteers from Eastern Ghouta’s other 11 centres have been killed. They are Firas Joma’a, who was killed in Beit Sawa on 20 February 2018; Mohammad al-Masarwa, former director of the Civil Defence in Eastern Ghouta who was killed on 8 or 9 March 2018; Rif’at Idriss, who was killed in Zamalka on 13 March 2018; Ayman Jamaleddine, who was killed in Zamalka on 15 March 2018; Hassan al-Husseini, who was killed in Saqba on 16 March 2018.

Targeting medical facilities and transports have taken place elsewhere in Syria since the uprising began in 2011 and after the country slipped into civil war. According to the UN Commission of Inquiry, attacks on hospitals, clinics, and medical points markedly increased in frequency as of October 2015 forcing hospitals and medical facilities to operate from basements to avoid being exposed to attack. The Commission said in a report released on 6 March 2018 that such attacks are part of a government “strategy to erode the viability of civilian life in opposition-held areas” in Syria. Deliberate attacks on health facilities and ambulances amount to war crimes.

Research for this blog was conducted by Cilina Nasser, an independent researcher, who interviewed three Civil Defence volunteers from Markaz 114 to obtain specific information on the attacks that targeted their facilities and ambulances. She also interviewed and communicated with another six volunteers from other centres of the Civil Defence in Eastern Ghouta, several doctors and media activists to understand the contextual situation, get relevant information and double check facts. There was daily communication with the sources and main interviews were conducted on 20 February, 1, 3, 4, 6, 10, and 11 March 2018.

Relevant photos and video material were viewed for the purpose of this research. Some are not published due to the graphic content or because people who appeared in video could not be reached to get their consent.

Limitations to research on Eastern Ghouta are mentioned in the previous blog, Kafr Batna: airstrike on a market, posted on 8 March 2018. Additional limitations include difficulties to get the exact numbers and names of casualties of some of the attacks documented below, because Civil Defence volunteers at Markaz 114 had no time to document such information due to the huge and exhausting workload and having to move to three different buildings between 1 March and 14 March 2018. Also, the humanitarian situation deteriorated, the bombardment intensified, some parts of Eastern Ghouta fell under government control and internet connection worsened, since at least 7 March 2018, making it more difficult to access contacts and to identify and reach new interviewees.

One main witness and source of information from Markaz 114 of the Civil Defence, Mohammad Hasheesh, was killed while on duty as detailed below. Mohammad Hasheesh was exceptionally polite even in distressful situations, generous in providing information, and patient in responding to questions and repeating answers through poor internet connection. I dedicate this blog to him.

Syria Civil Defence: Markaz 114 under attack

Markaz 114 of the Syria Civil Defence operated in at least five towns and villages of Eastern Ghouta’s al-Marj area that were until 4 March 2018 outside government control. They included al-Nashabiye, Otaya, Hazrama, Hosh al-Salhiye and Beit Nayem.

Volunteers of Markaz 114 moved outside al-Marj area after their building in Otaya came under attack on 1 March 2018 but continued to serve the people of al-Marj until at least 4 March 2018 when most residents fled to other towns and villages within Eastern Ghouta out of fear that advancing government forces would subject them to arbitrary arrest, torture, enforced disappearances or summary killings.

Markaz 114 volunteers has since stopped going to al-Marj but they continue operating elsewhere in Eastern Ghouta to this day. Like other Civil Defence centres, Markaz 114 volunteering services include transporting wounded people to hospital, evacuating civilians from areas under bombardment to safer places, extinguishing fires, and searching for and rescuing people trapped under the rubble.

During this offensive, ambulances belonging to or used by Markaz 114 of the Civil Defence were targeted on 19 and 28 February and 7 March 2018 resulting in the killing of four volunteers and wounding at least seven others.

Also, Markaz 114 building in Otaya was attacked on 1 March 2018; the team had to leave it and move their equipment to another building in the village of al-Asha’ri outside al-Marj, but it too was attacked on 6 March 2018; they moved again to a building in Erbin, which was hit on 12 March 2018; and as volunteers from Markaz 114 were moving equipment from their Erbin building to another location in another area in the early hours of 14 March, a missile landed around 30 meters away from their vehicle.

According to the Syrian American Medical Association (SAMS), 28 medical facilities were struck by 33 missiles between 18 February and 10 March 2018. And Civil Defence buildings and medical facilities do not use distinctive emblems as is generally required by international humanitarian law to avoid being targeted by government forces. Civil Defence ambulances usually have their logos and official name of the Civil Defence on the sides of their vehicles but do not use rooftop emergency lights.

As some hospitals and medical facilities are no longer operating, ambulances are driving longer distances to reach other medical facilities, and that is delaying urgent medical attention that may risk the lives of seriously injured individuals. Additionally, the longer the journey to the hospital, the riskier it is for the ambulance crew and the wounded individuals to be struck by missiles.

Interviewees consistently reported the presence of reconnaissance planes over Eastern Ghouta with several saying that there was a reconnaissance plane “all the time” and “24 hours a day” and one saying, “the reconnaissance plane does not leave the sky.” The role of reconnaissance planes is to collect images and observe manoeuvres of the enemy.

Given the precise government attacks on Civil Defence buildings and medical facilities and the reportedly extensive use of reconnaissance planes, Civil Defence volunteers and doctors interviewed for this blog said they believed that reconnaissance planes were monitoring the movement of ambulances to locate hospitals when unloading the wounded persons and to find Civil Defence buildings when ambulances returned to their centres.

Al-Marj Hospital under attack – 19 February 2018

Markaz 114 of the Civil Defence, located in Otaya and covering al-Marj area, used to transport wounded persons primarily to al-Marj Hospital, a medical facility that had gone underground to avoid being exposed to government attack.

Al-Marj Hospital was located in Sheefoniye, a village just outside al-Marj but considered safer than al-Marj’s villages and towns that were bombarded heavily because they were closer to the frontlines in the east part of Eastern Ghouta.

On 19 February 2018, the second day of the offensive, al-Marj Hospital was hit by shelling during the day, killing at least one person, Muhannad Marzouq, aged 29, who works as an anaesthetist at the hospital, according to a doctor who worked at the same medical facility.

A rescue team leader at the Civil Defence’s Markaz 114 who helped the anaesthetist recounted what happened that day:

“My team and I went in an ambulance to pick up wounded persons in Otaya, which was around 3km away from the frontline and was under heavy bombardment. There was a pilotless reconnaissance plane flying above us while we were collecting the wounded… we transported them to al-Marj Hospital. As soon as the ambulance arrived and as our crew members were opening the door to unload the wounded people, shells landed on the hospital… I jumped out of the ambulance and saw that a man who appeared to be a hospital staffer… he was wearing a white robe… had been seriously injured. I later knew that he was an anaesthetist. With the hospital under attack, I thought it was better to take him to another medical facility and that was around six kilometres away. It took us around three and the half minutes to get to the other hospital, because we drive our ambulances usually at high speed to avoid being hit.

We then returned to al-Marj Hospital to pick up more wounded people but found that an airstrike had struck the building during our journey to and from the other hospital… and part of the building collapsed, blocking the ambulance reception area where we usually unload the wounded. So the ambulance crew helped in evacuating the wounded persons who were brought in from an earlier attack that day and transported them to the other hospital, the one that is around six kilometres away.”

The hospital stopped operating due to the damage caused by the airstrike and because it was no longer safe, according to both the Civil Defence rescue team leader and the doctor who worked there.

Ambulance targeted: killing of the Shaker family – 19 February 2018

In less than an hour of the hospital attack, an ambulance from Markaz 114 of the Civil Defence went to collect wounded people from a residential area in Otaya in broad daylight. Two ambulances were dispatched to the scene. One took away wounded persons; the other ambulance wanted to evacuate the family of Sa’id Shaker, his children and grandchildren, all around 20, to a safer area when it came under attack killing at least 10 who were members of the Shaker family and their in-laws or relatives including at least four women and at least one child.

The Civil Defence provided a list of 24 people killed in al-Marj on that day, including the names of those killed in this incident. To avoid confusion, only the names of eight victims who the Civil Defence volunteers were certain they were part of or related to the Shaker family are published here: Sa’id Shaker, Elham al-Zabdini Shaker (woman), Bashir Taha, Mariam Shaker (woman), Sa’id Othman Shaker, Mohammad Sa’id Shaker, Asma’a Shaker (woman), Marwa Youness (woman), Hiyam al-Zabdini (child).

Other family members who survived this attack were wounded, according to one Civil Defence ambulance crew member, Mohammad Hasheesh, who described what happened:

“We were helping injured people at a place that was hit in Otaya, and we were surprised to see women and children in another home calling for help and pleading with us to be evacuated to a safer area, saying: ‘for God’s sake, get us out of here, please, they’re bombing us.’ The first ambulance collected the wounded people and left, and we decided to take this family to safety.

We went to the room they were sheltering in and started helping them to go to the ambulance. I carried out some of their belongings, clothes and stuff, and as I was getting out of their home, I heard a very loud explosion, and there was thick black smoke and lots of dust… I looked and saw that our ambulance had been targeted by an airstrike and it was badly damaged… all the family members that we were supposed to evacuate were now either killed or wounded. It was a very tough scene… there were men, women and children all turned into body parts strewn around on the road.”

With al-Marj Hospital already hit earlier that day, the wounded members of the Shaker family and their relatives were transported to another hospital.

The ambulance, one of three at the Civil Defence’s Markaz 114 in al-Marj area, was damaged beyond repair. Markaz 114 was now left with only two ambulances.

Nine days later, a second ambulance belonging to Markaz 114 of the Civil Defence was hit in Otaya, killing rescue team leader Mahmoud al-Kilani and injuring other crew members as well as wounding people who were being transported to the hospital. The attack on the ambulance took place on 28 February 2018 at around 11am, that is during the Russian-declared daily five-hour humanitarian pause that supposedly began a day earlier, on 27 February 2018, and that was scheduled to last from 9am to 2pm local time.

According to his colleagues, Mahmoud al-Kilani headed immediately to the targeted area that was less than two-minute drive to collect wounded persons. Within minutes from the first airstrike, a second missile hit the ambulance in a tactic that is known to Civil Defence rescuers as a ‘double-tap strike,’ during which two missiles strike in rapid succession hitting the same target. A Civil Defence rescue team leader who rushed to the scene described what happened:

“I saw Mahmoud, he was martyred… it was clear. Another two ambulance crew members were injured. There were around 10 other wounded people, mainly women and children… some sustained new injuries in addition to those they received in the earlier strike… I also saw three dead bodies. I do not know if they were killed on the first or second strike.

I packed my ambulance with all the wounded people quickly and left behind Mahmoud and the other three bodies. That’s what we usually do. We prioritise the treatment of the wounded and get them out of there immediately in case the aircraft returns and strikes again… and so that they receive medical treatment as quickly as possible.”

Mohammad Hasheesh introduced this researcher to the rescue team leader who witnessed the aftermath of the attack on the ambulance. He was also arranging an interview for this researcher with an ambulance crew member who was injured by the airstrike that killed Mahmoud al-Kilani to give information on whether the second strike occurred when the ambulance arrived to the scene of the attack or while transporting the wounded to hospital; whether the three bodies found were killed by the first or second attack; whether all 10 wounded persons were injured from the first strike or were there some who were unharmed but needed evacuation; how many were injured from the second strike. Mohammad Hasheesh was killed (read below) a few days later before arranging the interview.

The targeted ambulance was damaged beyond repair leaving Markaz 114 of the Civil Defence with only one ambulance.

Since the beginning of the offensive, Markaz 114 of the Civil Defence was hit by shrapnel from shells and missiles landing near or around its building, sometimes 25 to 30 meters away, according to its volunteers.

On 1 March 2018 between 10:30am and 11:30am, Markaz 114 building was hit by two barrel bombs, dropped from a helicopter, that destroyed around one third of the building, according to Civil Defence volunteers. No one was injured and the vehicles belonging to Markaz 114 were slightly damaged having their glass shattered and their tires punctured.

Due to the targeting of their building and the intensity of bombardment on al-Marj, the Civil Defence volunteers had to relocate to al-Asha’ri, a village close to but outside al-Marj area so that they would continue serving the wounded people of al-Marj. A rescue team leader said:

“Our building was the only one that was hit on our street that day. We spent two years in that building and so it was well prepared with all what we needed: tools and equipment required for our work; a warehouse with fuel for our vehicles; buckets of soil that we ourselves have grinded until turned into powder for extinguishing fire caused by napalm, lots of stuff. Now that it [the building] became a target, we had to move to a building in a safer area.”

On 4 March 2018, the majority of residents left al-Marj as government forces were advancing and therefore Markaz 114 volunteers who by now had relocated to al-Asha’ri started focusing their work on nearby towns and villages under attack elsewhere in Eastern Ghouta, such as Hamouriye and Misraba.

On 6 March 2018 between 11:45am and 12pm, the building that the volunteers of Markaz 114 moved to in al-Asha’ri was hit by a barrage of shelling. Around 14 volunteers rushed to a shelter in the building, including one who said he had a light injury to his hand when a wall collapsed on him. He said:

“It took us three days to pack everything and move our stuff to the new place and we were doing that even at 2am to avoid being monitored by the [reconnaissance] aircraft… and just today we erected sandbags to protect the building, and now it’s hit and we have to move again.”

Two ambulances targeted: three volunteers killed – 7 March 2018

On 7 March 2018 after 9:30pm, the Civil Defence’s Markaz 114 was alerted about people affected by a suspected chlorine gas attack in Hamouriye, a town in Eastern Ghouta. Two ambulances were dispatched, including one that Markaz 114 borrowed from another Civil Defence centre after losing two ambulances in previous attacks as detailed above.

The two ambulances were carrying nine Civil defence volunteers when they were hit by a missile killing Ismail Hasheesh and Yasser Sobhiye, and injuring Mohammad Hasheesh, who died the following morning. Another five volunteers were injured. Other people living in nearby buildings were also killed and wounded but the number and identity of the casualties were not available.

A Civil Defence volunteer, who was in one of the two ambulances that were hit and sustained bruises to his back, recounted what happened:

“We went to a basement where people were hiding from the bombardment and they were affected by the chlorine attack, and we took them to hospital. We then went to a second basement and evacuated people there and took those affected by chlorine to hospital. While we were on our way to the third shelter, around 500 meters before we reached our destination, we were hit by a missile… our ambulance flew probably two meters off the ground from the pressure of the missile before it landed. The inside of the ambulance was falling on us… I got out of our vehicle and saw that the second ambulance that was driving behind us had been badly damaged… I saw Mohammad [Hasheesh], he was thrown out of the vehicle and was lying on the ground with one leg on the ambulance’s sliding door. He was conscious and spoke to me. Ismail [Hasheesh], Mohammad’s brother, was dead inside the ambulance and without a head… Yasser [Sobhiye] was thrown around 10 meters away from the ambulance. He had an injury to his head.”

Another volunteer, a rescue team leader who rushed to the scene when he learned that his colleagues had been attacked, described what happened:

“I heard my brother on the walkie talkie calling another Civil Defence centre for help saying that our ambulances were hit… I went there by a motorcycle because our centre had no more ambulances… when I arrived, it was dark and, as usual, we didn’t switch on the lights. I could hear people screaming and shrieking from pain or calling for help… others were running away right and left… there were also dead bodies lying here and there, but they weren’t my colleagues’… they were probably for people who lived in the area.

I didn’t know that my brother, who had called for help, was actually among the crew that was targeted until I saw him… the bombardment doesn’t stop these days so our ambulances are dispatched all the time and I can’t keep track of who’s in them… my brother was testifying that there is no God but Allah and I asked him where our crew members were. He was still in shock and replied, ‘here, but I don’t know where they are.’ I asked him which volunteers were in the two ambulances, and my brother gave me the names.

I started calling their names out loud… I called out, ‘Mohammad, Abu Wissam [in reference to Ismail whose eldest son is called Wissam], Yasser, there was no answer… I continued to call out their names and heard someone saying, ‘I’m here, I’m here.’ It was Yasser… he was injured so we carried him and placed him in an ambulance for the Civil Defence from a different centre that came to help our crew, and we continued our search for the others.

I found Mohammad. He was outside the ambulance’s sliding door with one foot on the ambulance… He too was badly injured, his back was badly hit… but he was conscious and spoke to me… he asked to be taken away immediately and we carried him to the ambulance… we then found Ismail inside the ambulance… he was dead and headless. Earlier, I called out his name while I was next to the ambulance and he was lying dead inside but I didn’t know… although at one point I looked inside the ambulance but didn’t see him… we couldn’t find his head.

We continued the search and helped other wounded people until we evacuated them all.”

Yasser Sobhieh passed away that night and Mohammad Hasheesh underwent a surgical operation overnight but succumbed to his wounds and passed away the following morning on 8 March 2018.

According to a Civil Defence volunteer, brothers Mohammad and Ismail Hasheesh used to work mostly on different shifts so that one of them would take care of their brother, who sustained an injury that left him paralysed several years ago.

All three Civil Defence volunteers were buried in the town of Hazze in Eastern Ghouta, because their hometowns had fallen under the control of government forces, according to one volunteer.

With this attack, Markaz 114 lost all of its ambulances.

Markaz 114 building in Erbin attacked – 12 March 2018

On 12 March 2018, a barrel bomb was dropped on the building that Markaz 114 had moved to destroying a fire truck, which was donated by the director of Markaz 114.

At around 2am on 14 March 2018, the volunteers were moving their equipment from the Erbin building to another location when a missile landed around 30 meters away from their vehicle.

In less than a month, volunteers of Markaz 114 have witnessed the killings of their colleagues, showed up to work even after sustaining injuries, and endured barrel bombs and missiles wrecking their buildings, ambulances and other property. At the same time, they have been attending to their families, moving them to safer towns, finding them basements to shelter in, and struggling to provide them with their basic needs.

But nothing has stopped them. Markaz 114 of the Civil Defence continues to operate to this day as do the other 11 Civil Defence centres in Eastern Ghouta. Their volunteers continue to respond to emergencies, sometimes even by using a motorcycle or by walking towards targeted locations to transport the wounded, evacuate those at risk, or other rescue missions that save lives.